NRS 430 Topic 4 DQ 1 Outline the process for the development of nursing standards of practice for your state

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Topic 4 DQ 1

Apr 25-27, 2022

Outline the process for the development of nursing standards of practice for your state, including discussion of the entities involved in developing the standards of practice and how the standards of practice influence the nursing process for your areas of specialty.

REPLY TO DISCUSSION

Billie Gabbard

Posted Date

Apr 25, 2022, 4:19 PM

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CAT: COMPACT Licensure

The addition of compact licensure to the nurse licensure process allows nurses to practice in other compact partner states. In your opinion, would it be beneficial to have national professional practice standards versus state oversight? Why or why not?

Billie

Chioma Nwachukwu

replied toBillie Gabbard

Apr 26, 2022, 8:04 AM

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Hello Billie,

I believe the compact licensure has been very helpful. It allows the holder to practice in all participating states in the US. Considering the recent pandemic, nurses were able to move from one locatiion to another to care for severely sick. This i believe was possible because of the compact license to practice.

Having a national professional practice standard or state specific standard has its cons and pros.

The advantage of a federal standard of practice is uniformity in practice and licensure. For instance, in my home country, there is just one board of nursing referred to as the nursing council and they help in maintaining standard of care in all states of the federation as well as issuance of liscenses. Hence, a professional nurse in one state can practice in all the 36 states of the country.

The downside of this system could be delay in processes and procedures such as registration, verification and issuing of liscenses.

Coming to the US, i think having a centralized system might be a bit cumbersome to maintain because of the ever growing population size and changing system in healthcare. Also, it would be easier to manage the ever growing population and nursing practice within the state level.

- BG

Billie Gabbard

replied toChioma Nwachukwu

Apr 27, 2022, 3:57 AM

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Chioma,

You bring up a valid point of a national council to regulate the practice. Larger numbers of nurses to oversee would be a challenge. Perhaps the national council could have state committees to oversee the practices using the national standards.

Billie

Rose Francis

replied toBillie Gabbard

Apr 26, 2022, 12:17 PM

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In my country, there is one board of nursing called the ‘Nursing council’, and they help in monitoring the standard of care in all states of the federation. The nursing council will verify where I studied and the state health authority will issue the license to practice nursing in any state. So a professional nurse can practice nursing in all states of the country. The Nursing council will register, verify and issue licenses. And it is renewed every five years. To practice outside the country, a special authorization is required. In the United states, each state allows nursing practice after verifying the nursing certificate and allowing to practice as an RN nurse.

- BG

Billie Gabbard

replied toRose Francis

Apr 27, 2022, 3:58 AM

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Thank you, Rose. In your opinion, since you have licensure in your home country as well as the U.S. is one better?

Billie

- - RF

Rose Francis

replied toBillie Gabbard

Apr 29, 2022, 12:51 PM

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If one can meet the competencies of the NCLEX, safe practice should be the same everywhere. In nursing, basic study is the same, but teaching methods can be different. Although the studies and practice are similar, tradition, culture and people are different. And one should have dedication and compassion to nursing job. Only then can one be sincere to their patients.

Cassidy Wright

replied toBillie Gabbard

Apr 27, 2022, 1:13 PM

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Hi Billie,

In my opinion I think absolutely it would be more stream line and beneficial to all those involved (patients, nurses, and the state legislators) to have national professional practice standards versus state oversight. For example, looking at the pandemic, different states needed nurses at different times through the waves of COVID, having a nursing license that had the same scope of practice and nationally standardized would help streamline nurses to work around the country at any given time. This can also help nurses when moving states or location if they decide to relocate they don’t have to go through the hoops of getting an RN license that permits them to practice in whatever state they are going to. I think overall its better to have one golden standard across the country versus having different scopes of practices, rules and regulations for RN’s in different states. Having a national professional practice standard would make for safer better regulated conditions and overall better patient outcomes across the country.

-Cassidy

- BG

Billie Gabbard

replied toCassidy Wright

Apr 28, 2022, 4:05 AM

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Replies to Cassidy Wright

Thank you, Cassidy. COVID provides a great example of why it would be beneficial to support national standards.

Billie

Stephanie Jackson

replied toBillie Gabbard

Apr 27, 2022, 10:08 PM

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Billie, yes I do believe it would be beneficial to have a national standardization in certain instances. Especially in times like we have seen with the pandemic. So maybe an emergency compact licensure would be more ideal. This would still give each state oversight ability and responsibility, not to mention autonomy.

- BG

Billie Gabbard

replied toStephanie Jackson

Apr 28, 2022, 4:06 AM

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Stephanie,

Safe practice should be the same everywhere. If one meets the competencies of the NCLEX, then it would be ideal that one be granted the ability to do use that licensure consistently across the states.

Billie

Carly Wallmeyer

replied toBillie Gabbard

Apr 29, 2022, 1:27 PM

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In my opinion, I think that it would be benficial for there to be a national licensure for nurses. I think this could be both helpful for the nurse and patient. Quality of standards being universal across the states will allow the nurse flexibility to travel or move states without delay in work. Being able to move from state to state working with the same scope of practice and standard of care can also be beneficial in a state of emergency or even in a pandemic. This also insures and equally in care nation wide through the nursing profession, so patients can expect the same great care wherever they are in the country. On the other hand, I do feel that it is important to have nurses and health care professionals from various fields to have input on the nursing scope of practice and standard of care.

Stephanie Jackson

Posted Date

Apr 27, 2022, 10:04 PM

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Replies to Billie Gabbard

The practice of nursing is in a constant state of motion and in an effort to create guidelines for standards of practice, a “list of competencies to help nurses better understand the expectations…these include assessment, diagnosis, planning, coordination of care, health teaching consultation, prescriptive authority, and evaluation” (Dean, 2018). The National Council of State Boards of Nursing (NCSBN) assists all fifty states, including Oklahoma, in developing guidelines for standards of care for its Board of Nursing (BON) (ncsbn.org). These guidelines set forth by the NCSBN encourage the state of Oklahoma to use evidence-based practice in its Nurse Practice Act (NPA) which promotes patient safety and outcomes (Huynh, 2021).

With all states using the NCABN, a sense of continuity and standardization can be felt in the profession of nursing. With developments in medicine and other interventions, it is vital in the nurse role to understand what his/her role is in regards to patient safety and outcomes. By using the standards of practice put forth by the state of Oklahoma’s BON, the safety of patients is in the forefront of the care that is provided.

In the post-anesthesia care unit (PACU), the five components of the nursing process are utilized (Dean, 2018). An example of this would be a patient who presents to the PACU after a shoulder arthroscopy. An initial assessment of the patient shows the patient to be moaning, wincing, as well as tachycardia and hypertensive; this is the first step in the nursing process. The second step would be to provide a diagnosis. What is the problem? The patient reports pain (as 8 on a scale of 0-10) as a result of surgery as seen by increased heart rate and blood pressure as well as pain score. The third step is planning/outcomes, what can the nurse implement as far as interventions and possible pharmacologic strategies to alleviate the patient’s pain and what could the outcomes of said implementations be? The fourth step is implementation. The nurse carries out the intervention that was previously evaluated, in this case the nurse decides to dim the lights, quiet the room, and provide the patient with pain medication per orders given by provider. The last step is evaluation. Did the intervention work? Is the patient’s pain alleviated? This step often requires another assessment to determine the effectiveness of the intervention. The Standards of Practice set forth by the BON guides this nurse process in that the nurse is able to evaluate the problem, consider options for implementing interventions then evaluating the outcomes, all based on the appropriate standards of care put in place.

Dean, Julie. (2018). Practice and Competency Development. Dynamics in Nursing Art & Science of Professional Practice

NRS 430 Topic 4 DQ 1 Outline the process for the development of nursing standards of practice for your state

Ch.3. https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/dynamics-in-nursing_art-and-science-of-professional-practice_1e.php

Huynh, A.P., Haddad, L.M. (July 22, 2021). Nursing Practice Act. Stat Pearls. ncbi.nlm.nih.gov/books/NBK559012/

ncsbn.org/decision-making-framework.htm

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Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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